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Clinical Outcomes of Large (> 10 mm) Unruptured Posterior Circulation Aneurysms and Their Predictors

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Abstract
Objective : The treatment of large aneurysms of the posterior circulation is complicated and remains challenging. We here analyzed our institutional clinical outcomes of large unruptured aneurysms of the posterior circulation.

Methods : This study included 56 patients who presented with a large (>10 mm) unruptured aneurysm of the posterior circulation between 2002 and 2018.

Results : There were 18 (32.1%) male and 38 (67.9%) female patients, with a mean age of 53.4 years. The most common location was the vertebral artery, followed by the basilar tip and posterior cerebral artery. The median follow-up duration was 29 months. Eighteen patients (32.1%) were treated by transcranial surgery and 38 (67.9%) were treated by endovascular treatment (EVT). Post-treatment complications occurred in 16 patients (28.6%), with there being no significant difference between the transcranial surgery and EVT groups. Complete obliteration was achieved in 30 patients (53.6%), with there being no statistically significant difference between the transcranial surgery and EVT groups. Recurrence occurred in 17 patients (30.4%), and the rate of recurrence was higher in the EVT group than in the transcranial surgery group (39.5% vs. 11.1%, p=0.03). Forty-four (84%) of 56 patients showed a favorable functional outcome. In saccular aneurysm, EVT was negative predictor of worsening of functional status.

Conclusion : Treatment of these aneurysms harbors an inherent high risk of morbidity. No superiority was found between transcranial surgery and EVT in terms of complications and complete obliteration, but transcranial surgery showed a higher treatment durability than EVT.
Author(s)
변준호박원형박중철안재성
Issued Date
2021
Type
Article
Keyword
AneurysmLargeUnruptured · Surgery · Treatment outcome · Complications · Posterior circulation
DOI
10.3340/jkns.2020.0028
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7628
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9629428&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Clinical%20Outcomes%20of%20Large%20(%3E%2010%20mm)%20Unruptured%20Posterior%20Circulation%20Aneurysms%20and%20Their%20Predictors&offset=0&pcAvailability=true
Publisher
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY
Location
대한민국
Language
영어
ISSN
2005-3711
Citation Volume
64
Citation Number
1
Citation Start Page
39
Citation End Page
50
Appears in Collections:
Medicine > Medicine
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